Öz
Amaç: Bu çalışmanın amacı, acil servislere minör kafa travması ile başvuran çocuklarda kraniyal bilgisayarlı tomografi (BT) taramalarının radyasyon maruziyetini değerlendirmektir.
Gereç ve Yöntemler: Minör kafa travması nedeniyle acil serviste BT çekilen 1199 hastanın radyasyon dozu hesap edilmiştir.
Bulgular: Beyin BT çekilen 0-5 yaş arası çocuklarda 5-16 yaş arası çocuklara göre anlamlı olarak daha yüksek dozda radyasyona maruz kaldıklarını tespit ettik (p<0.001). Servikal BT ve abdominal BT çekilen çocuk hastalarda yaş gruplarına göre radyasyon maruziyetleri arasında anlamlı bir fark yoktu (sırasıyla p=0.838, p=0.106). Toraks BT çekilen çocuk hastalarda 10-16 yaş arası çocuklarda 0-1 yaş arası çocuklara göre anlamlı olarak daha yüksek dozda radyasyona maruz kaldıkları tespit edildi (p=0.001).
Sonuç: Acil servise kafa travması ile gelen çocuklarda kraniyal BT kullanımının klinik gözlem ve iyonizan radyasyonun olumsuz etkileri konusunda hasta - yakınlarının bilgilendirilmesi ile ve istem yapan doktorların eğitimi ile azaltılabileceğini öneriyoruz.
Anahtar Kelimeler
Bilgisayarlı tomografi çocuklar kafa travması radyasyon dozu
Destekleyen Kurum
Yok
Kaynakça
- Wendling-Keim DS, König A, Dietz H-G, Lehner M. Ambulatory or inpatient management of mild TBI in children: a post-concussion analysis. Pediatric surgery international 2017;33(2):249-61.
- Olsen M, Vik A, Nilsen TIL, Uleberg O, Moen KG, Fredriksli O, et al. Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway. European journal of paediatric neurology 2019;23(3):500-6.
- Griffey RT, Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. American Journal of Roentgenology 2009;192(4):887-92.
- Amis Jr ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM, et al. American College of Radiology white paper on radiation dose in medicine. Journal of the american college of radiology 2007;4(5):272-84.
- Tipnis S, Rieter W, Patel D, Stalcup S, Matheus M, Spampinato M. Radiation Dose and Image Quality in Pediatric Neck CT. American Journal of Neuroradiology 2019;40(6):1067-73.
- Mastrangelo M, Midulla F. Minor head trauma in the pediatric emergency department: decision making nodes. Current pediatric reviews 2017;13(2):92-9.
- Klora M, Zeidler J, Bassler S, Hirsch FW, Gosemann J-H, Lacher M, et al. Frequency of neuroimaging for pediatric minor brain injury is determined by the primary treating medical department. Medicine 2019;98(28).
- Cynthia McCollough C, Cody D, Edyvean S, Geise R, Gould B, Keat N, et al. The Measurement, Reporting, and Management of Radiation Dose in CT. American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740-3846; 2008:12-3.
- Stanley RM, Hoyle Jr JD, Dayan PS, Atabaki S, Lee L, Lillis K, et al. Emergency department practice variation in computed tomography use for children with minor blunt head trauma. The Journal of pediatrics 2014;165(6):1201-6. e2.
- Council NR. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2. 2006.
- Unscear S. effects of Ionizing Radiation. United Nations, New York 2000:453-87.
- Stather J, Muirhead C, Cox R. Radiation-induced cancer at low doses and low dose rates. Radiological Protection Bulletin 1995:8-12.
- Stopa BM, Amoroso S, Ronfani L, Neri E, Barbi E, Lee LK. Comparison of minor head trauma management in the emergency departments of a United States and Italian Children's hospital. Ital J Pediatr 2019;45(1):24.
- Kuppermann N, Holmes JF, Dayan PS, Hoyle JD, Atabaki SM, Holubkov R, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. The Lancet 2009;374(9696):1160-70.
- Dunning J, Daly JP, Lomas J, Lecky F, Batchelor J, Mackway-Jones K. Derivation of the children’s head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Archives of disease in childhood 2006;91(11):885-91.
- Osmond MH, Klassen TP, Wells GA, Correll R, Jarvis A, Joubert G, et al. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. Cmaj 2010;182(4):341-8.
- Schonfeld D, Bressan S, Da Dalt L, Henien MN, Winnett JA, Nigrovic LE. Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice. Archives of disease in childhood 2014;99(5):427-31.
- Karpas A, Finkelstein M, Reid S. Which management strategy do parents prefer for their head-injured child: immediate computed tomography scan or observation? Pediatric emergency care 2013;29(1):30-5.
- Boutis K, Cogollo W, Fischer J, Freedman SB, Ben David G, Thomas KE. Parental knowledge of potential cancer risks from exposure to computed tomography. Pediatrics 2013;132(2):305-11.
Öz
Objective: The present study aims to evaluate radiation exposure in cranial computed tomography (CT) scans of children who were admitted to an emergency service due to minor cranial trauma.
Material and Methods: Radiation exposure doses of 1199 patients with CT scans due to minor cranial trauma in an emergency service were calculated.
Results: It was found that children aged 0 to 5 were exposed to a significantly higher radiation dose compared to those aged 5 to 16. (p<0.001). However, no significant differences were observed among children with cervical and abdominal CT scans in terms of their age groups (p=0.838 and p=0.106, respectively). Finally, it was observed that among children with thorax CT scans, those aged 10 to 16 were exposed to a significantly higher radiation dose compared to those aged 0 to 1. (p=0.001).
Conclusion: We suggest that the use of cranial CT scan in children admitted to an emergency service due to cranial trauma can be reduced by clinical monitoring, informing the patient and parents about negative effects of ionizing radiation and training physicians about CT scan orders.
Anahtar Kelimeler
Kaynakça
- Wendling-Keim DS, König A, Dietz H-G, Lehner M. Ambulatory or inpatient management of mild TBI in children: a post-concussion analysis. Pediatric surgery international 2017;33(2):249-61.
- Olsen M, Vik A, Nilsen TIL, Uleberg O, Moen KG, Fredriksli O, et al. Incidence and mortality of moderate and severe traumatic brain injury in children: A ten year population-based cohort study in Norway. European journal of paediatric neurology 2019;23(3):500-6.
- Griffey RT, Sodickson A. Cumulative radiation exposure and cancer risk estimates in emergency department patients undergoing repeat or multiple CT. American Journal of Roentgenology 2009;192(4):887-92.
- Amis Jr ES, Butler PF, Applegate KE, Birnbaum SB, Brateman LF, Hevezi JM, et al. American College of Radiology white paper on radiation dose in medicine. Journal of the american college of radiology 2007;4(5):272-84.
- Tipnis S, Rieter W, Patel D, Stalcup S, Matheus M, Spampinato M. Radiation Dose and Image Quality in Pediatric Neck CT. American Journal of Neuroradiology 2019;40(6):1067-73.
- Mastrangelo M, Midulla F. Minor head trauma in the pediatric emergency department: decision making nodes. Current pediatric reviews 2017;13(2):92-9.
- Klora M, Zeidler J, Bassler S, Hirsch FW, Gosemann J-H, Lacher M, et al. Frequency of neuroimaging for pediatric minor brain injury is determined by the primary treating medical department. Medicine 2019;98(28).
- Cynthia McCollough C, Cody D, Edyvean S, Geise R, Gould B, Keat N, et al. The Measurement, Reporting, and Management of Radiation Dose in CT. American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740-3846; 2008:12-3.
- Stanley RM, Hoyle Jr JD, Dayan PS, Atabaki S, Lee L, Lillis K, et al. Emergency department practice variation in computed tomography use for children with minor blunt head trauma. The Journal of pediatrics 2014;165(6):1201-6. e2.
- Council NR. Health risks from exposure to low levels of ionizing radiation: BEIR VII phase 2. 2006.
- Unscear S. effects of Ionizing Radiation. United Nations, New York 2000:453-87.
- Stather J, Muirhead C, Cox R. Radiation-induced cancer at low doses and low dose rates. Radiological Protection Bulletin 1995:8-12.
- Stopa BM, Amoroso S, Ronfani L, Neri E, Barbi E, Lee LK. Comparison of minor head trauma management in the emergency departments of a United States and Italian Children's hospital. Ital J Pediatr 2019;45(1):24.
- Kuppermann N, Holmes JF, Dayan PS, Hoyle JD, Atabaki SM, Holubkov R, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. The Lancet 2009;374(9696):1160-70.
- Dunning J, Daly JP, Lomas J, Lecky F, Batchelor J, Mackway-Jones K. Derivation of the children’s head injury algorithm for the prediction of important clinical events decision rule for head injury in children. Archives of disease in childhood 2006;91(11):885-91.
- Osmond MH, Klassen TP, Wells GA, Correll R, Jarvis A, Joubert G, et al. CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury. Cmaj 2010;182(4):341-8.
- Schonfeld D, Bressan S, Da Dalt L, Henien MN, Winnett JA, Nigrovic LE. Pediatric Emergency Care Applied Research Network head injury clinical prediction rules are reliable in practice. Archives of disease in childhood 2014;99(5):427-31.
- Karpas A, Finkelstein M, Reid S. Which management strategy do parents prefer for their head-injured child: immediate computed tomography scan or observation? Pediatric emergency care 2013;29(1):30-5.
- Boutis K, Cogollo W, Fischer J, Freedman SB, Ben David G, Thomas KE. Parental knowledge of potential cancer risks from exposure to computed tomography. Pediatrics 2013;132(2):305-11.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 10 Kasım 2023 |
| Yayımlanma Tarihi | 20 Kasım 2023 |
| Gönderilme Tarihi | 18 Kasım 2022 |
| Kabul Tarihi | 26 Aralık 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 18 Sayı: 3 |
